| Entity Name: | SOUTH FLORIDA SPINE AND ORTHOPEDICS, LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 22 Sep 2016 (8 years ago) |
| Document Number: | L16000178123 |
| FEI/EIN Number | 82-0788461 |
| Mail Address: | 1137 BOCA COVE LN, HIGHLAND BEACH, FL 33487 |
| Address: | 4515 Wiles Rd., Suite 201, Coconut Creek, FL 33073 |
| ZIP code: | 33073 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437791688 | 2019-10-09 | 2021-11-27 | 4515 WILES RD STE 201, COCONUT CREEK, FL, 330733414, US | 4515 WILES RD STE 201, COCONUT CREEK, FL, 330733414, US | |||||||||||||||||||
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| Phone | +1 561-498-2000 |
| Fax | 5614967074 |
| Phone | +1 954-500-4554 |
| Fax | 9544000904 |
Authorized person
| Name | JOHN MALLOY |
| Role | OWNER |
| Phone | 7178291570 |
Taxonomy
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SOUTH FLORIDA SPINE AND ORTHOPEDICS 401(K) PLAN | 2023 | 820788461 | 2024-10-14 | SOUTH FLORIDA SPINE AND ORTHOPEDICS | 3 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-10-14 |
| Name of individual signing | DR. JOHN MALLOY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2020-01-01 |
| Business code | 621310 |
| Sponsor’s telephone number | 7178291570 |
| Plan sponsor’s address | 2225 SW 14TH PL, BOCA RATON, FL, 33486 |
Signature of
| Role | Plan administrator |
| Date | 2024-10-14 |
| Name of individual signing | DR. JOHN MALLOY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621310 |
| Sponsor’s telephone number | 7178291570 |
| Plan sponsor’s address | 2225 SW 14TH PL, BOCA RATON, FL, 33486 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-15 |
| Name of individual signing | DR. JOHN MALLOY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2020-01-01 |
| Business code | 621310 |
| Sponsor’s telephone number | 7178291570 |
| Plan sponsor’s address | 2225 SW 14TH PL, BOCA RATON, FL, 33486 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-15 |
| Name of individual signing | DR. JOHN MALLOY |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| MALLOY IV, JOHN P | Agent | 1137 BOCA COVE LN, HIGHLAND BEACH, FL 33487 |
| Name | Role | Address |
|---|---|---|
| The Malloy Family Revocable Living Trust | Authorized Member | 2225 SW 14TH PL, BOCA RATON, FL 33486 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-28 | 4515 Wiles Rd., Suite 201, Coconut Creek, FL 33073 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-28 | 1137 BOCA COVE LN, HIGHLAND BEACH, FL 33487 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-10 | 4515 Wiles Rd., Suite 201, Coconut Creek, FL 33073 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-28 |
| ANNUAL REPORT | 2023-01-10 |
| ANNUAL REPORT | 2022-02-20 |
| ANNUAL REPORT | 2021-04-11 |
| ANNUAL REPORT | 2020-03-11 |
| ANNUAL REPORT | 2019-03-18 |
| ANNUAL REPORT | 2018-05-10 |
| ANNUAL REPORT | 2017-03-26 |
| Florida Limited Liability | 2016-09-22 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
